By Maria Konnikova
This is the third piece in a three-part series on sleep. Read part one, on falling asleep, and part two, on sleeping and dreaming.
Did you get enough sleep last night? Are you feeling fully awake, like your brightest, smartest, and most capable self? This, unfortunately, is a pipe dream for the majority of Americans. “Most of us are operating at suboptimal levels basically always,” the Harvard neurologist and sleep medicine physician Josna Adusumilli told me. Fifty to seventy million Americans, Adusumilli says, have chronic sleep disorders.
In a series of conversations with sleep scientists this May, facilitated by a Harvard Medical School Media Fellowship, I learned that the consequences of lack of sleep are severe. While we all suffer from sleep inertia (a general grogginess and lack of mental clarity), the stickiness of that inertia depends largely on the quantity and quality of the sleep that precedes it. If you’re fully rested, sleep inertia dissipates relatively quickly. But, when you’re not, it can last far into the day, with unpleasant and even risky results.
Many of us have been experiencing the repercussions of inadequate sleep since childhood. Judith Owens, the director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital, has been studying the effects of school start times on the well-being of school-age kids—and her conclusions are not encouraging. Most adults are fine with about eight hours of sleep, but toddlers need around thirteen hours, including a daytime nap. Teens need around nine and a half hours; what’s more, they tend to be night owls, whose ideal circadian rhythm has them going to bed and waking up late. As schools have pushed their start times earlier and earlier—a trend that first started in the sixties, Owens says—the health effects on students have been severe.

By Kenneth Miller
At first, no one noticed that Joe Borelli was losing his mind — no one, that is, but Borelli himself. The trim, dark-haired radiologist was 43 years old. He ran two practices, was an assistant professor at the Medical University of South Carolina and played a ferocious game of tennis. Yet he began to have trouble recalling friends’ names, forgot to run important errands and got lost driving in his own neighborhood. He’d doze off over paperwork and awaken with drool dampening his lab coat.
Borelli feared he had a neurodegenerative disease, perhaps early onset Alzheimer’s. But as a physician, he knew that memory loss coupled with fatigue could also indicate obstructive sleep apnea (OSA), a disorder in which sagging tissue periodically blocks the upper airway during slumber. The sufferer stops breathing for seconds or minutes, until the brain’s alarm centers rouse him enough to tighten throat muscles. Although the cycle may repeat hundreds of times a night, the patient is usually unaware of any disturbance.
Borelli checked in to a sleep clinic for tests, which came out negative. He went to a neurologist, who found nothing wrong. At another sleep clinic, Borelli was diagnosed with borderline OSA; the doctor prescribed a CPAP (continuous positive airway pressure) machine, designed to keep his airway open by gently inflating it. But he still awoke feeling exhausted, and he quit using the device after a couple of months.
Borelli’s fingers soon grew so clumsy that he couldn’t button his shirt cuffs.